Name: Kansai Karate
Address: Jijaws Street, Summer, QLD, 4300, AU
Telephone: +61732790655

07 3279 0655

GRADING REGISTRATION

Student name(Required)

Parent/Guardian Name (if under 18y)(Required)

Age(Required)

Current Grade(Required)

Eg. Red +2

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Class(Required)

Dojo(Required)

Grading Location(Required)

Fee(Required)

Total

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Card Details

Cardholder Name